Methylation of P16 and hMLH1 in Gastric Carcinoma

PURPOSE: We investigated the impacts of the methylation states of the P16 and the hMLH1 genes on pathogenesis and genetic expression of stomach cancer and their relationships with Helicobater pylori infection, and with other clinico-pathologic factors. MATERIAL AND METHODS: In our study, to detect protein expression and methylation status of the P16 and the hMLH1 genes in 100 advanced gastric adenocarcinomas, used immunohistochemical staining and methylation-specific PCR (MSP) and direct automatic genetic sequencing analysis. RESULTS: Methylation of the P16 gene was observed in 19 out of 100 cases (19%) and in the 18 of those cases (94.7%) loss of protein expression was seen. We were sble to show that loss of P16 gene expression was related to methylation of the P16 gene (kappa coefficient=0.317, P=0.0011). Methylation of the hMLH1 gene was observed in 27 cases (27%), and in 24 cases of those 27 cases (88.8%), loss of protein expression was seen, which suggested that loss of protein expression in the hMLH1 gene is related to methylation of hMLH1 gene (kappa coefficient=0.675, P<0.0001). Also methylation of the hMLH1 gene was related to age, size of the mass, and Lauren's classification. CONCLUSION: We found that methylation of DNA plays an important role in inactivation of the P16 and the hMLH1 genes. The methylation of the hMLH1 genes is significantly related to age, size of the mass, and Lauren's classification.

Expression of estrogen receptor beta, estrogen receptor alpha and cyclooxygenase II in advanced breast cancer / 한국유방암학회지

PURPOSE: Although the role of the estrogen receptor alpha (ER alpha, previously called the estrogen receptor) in breast cancer is well established, that of the second human estrogen receptor (ER), estrogen receptor beta (ER beta), remains uncertain. The expression of cyclooxygenase II (COX II) could also be regulated by sex steroids such as estrogen and progesterone. To investigate whether the expressions of the ER beta, ER alpha, and COX II are elevated in more aggressive breast cancers, the expression of the ER beta was studied by immunohistochemical staining in 20 primary breast cancer and original breast cancer tissues from 20 recurrent cancer patients, and its associations with ER alpha and cyclooxygenase (COX) II were evaluated. METHODS: Paraffin tissue sections from 40 breast cancers, surgically excised at the Department of Surgery, the Catholic University of Korea. were obtained. The immunohistochemical analysis was conducted on 20 non-recurrent, and 20 recurrent primary breast cancer tissues, using polyclonal antibodies to ER beta, ER alpha, and the corresponding monoclonal antibodies to COX II. RESULTS: Of the 40 patients, 15 (37.5%) were ER beta-positive, 30 (75%) were ER alpha-positive, and 24 (60%) were COX II-positive. The ER bata status was not related to the tumor size or menopausal status, but was related to the nodal status. The stati of ER alpha and COX II were not related to other clinico-pathological factors. The ER beta positivity was significantly more frequent in the study than the control group. (ER beta, p = 0.0222; ER alpha p = 0.1441; COX II, p = 1.00) The presence of ER beta was significantly related to the expression of ER alpha and COX II (p = 0.0455, p = 0.0381, respectively). CONCLUSION: These results suggest that the expression of ER beta is associated with early recurrence in breast cancer and the expression of COX II in the presence of ER beta implies the possibility of prognostic significance.

Expression of estrogen receptor beta, estrogen receptor alpha and cyclooxygenase II in advanced breast cancer / 한국유방암학회지

PURPOSE: Although the role of the estrogen receptor alpha (ER alpha, previously called the estrogen receptor) in breast cancer is well established, that of the second human estrogen receptor (ER), estrogen receptor beta (ER beta), remains uncertain. The expression of cyclooxygenase II (COX II) could also be regulated by sex steroids such as estrogen and progesterone. To investigate whether the expressions of the ER beta, ER alpha, and COX II are elevated in more aggressive breast cancers, the expression of the ER beta was studied by immunohistochemical staining in 20 primary breast cancer and original breast cancer tissues from 20 recurrent cancer patients, and its associations with ER alpha and cyclooxygenase (COX) II were evaluated. METHODS: Paraffin tissue sections from 40 breast cancers, surgically excised at the Department of Surgery, the Catholic University of Korea. were obtained. The immunohistochemical analysis was conducted on 20 non-recurrent, and 20 recurrent primary breast cancer tissues, using polyclonal antibodies to ER beta, ER alpha, and the corresponding monoclonal antibodies to COX II. RESULTS: Of the 40 patients, 15 (37.5%) were ER beta-positive, 30 (75%) were ER alpha-positive, and 24 (60%) were COX II-positive. The ER bata status was not related to the tumor size or menopausal status, but was related to the nodal status. The stati of ER alpha and COX II were not related to other clinico-pathological factors. The ER beta positivity was significantly more frequent in the study than the control group. (ER beta, p = 0.0222; ER alpha p = 0.1441; COX II, p = 1.00) The presence of ER beta was significantly related to the expression of ER alpha and COX II (p = 0.0455, p = 0.0381, respectively). CONCLUSION: These results suggest that the expression of ER beta is associated with early recurrence in breast cancer and the expression of COX II in the presence of ER beta implies the possibility of prognostic significance.

The Effect of Preoperative Concurrent Chemoradiation in Locally Advanced Rectal Cancer

PURPOSE: Tumor downstaging from preoperative chemoradiation has been associated with an increased probability of a sphincter-saving procedure and with improved local control and survival rate. We observed the effect and the prognostic value of pathologic tumor downstaging, including complete pathologic response to preoperative concurrent chemoradiation, resectability, sphincter-saving rate, disease- free survival, and overall survival in locally advanced rectal cancer patients. METHODS: From January 2000 to December 2003, we recruited a total 78 patients with computed tomography stages II and III rectal cancer which was treated by using preoperative concurrent chemoradiation; all patients had a radical resection with total mesorectal excision. Surgical resection was performed 6 to 8 weeks after completing the radiation therapy. The average follow up was 25.40+/-13.64 months. RESULTS: The number of patients according to CT stage before preoperative chemoradiation was 39 (II) and 39 (III). Tumor downstaging occurred in 51 (65.4%) patients, including 11 (14.1%) patients who had a complete pathologic response. Tumor size, radiation dose, and clinical stage were associated with tumor downstaging in the univariate analysis. None of the clinical or pathologic variables was associated with a complete pathologic response. The overall resectibality was 100%. The number of sphincter-saving procedures were 61 (78.2%). Recurrence occurred in 17 (21.8%) patients: local recurrence in 4 (5.1%) and distant metastasis in 13 (16.7%). None of the patients with a complete pathologic response recurred. Recurrences were 3 (17.6%)/7 (22.6%)/7 (36.8%) for pathologic stages I/II/III. Recurrence was more common among younger patients (P <0.05). Patients in the complete pathologic response group had more favorable disease-free survival compared with other group (yp stage I, II, III) (P=0.026). CONCLUSION: Preoperative concurrent chemoradiation for locally advanced rectal cancer seems to afford some potential advantages: high tumor response, resectability, and feasible sphincter preservation, and even a complete pathologic response. A complete pathologic response to preoperative chemoradiation is associated with an improved disease-free survival.

A Clinical Study of Abdominal Stab Wounds

BACKGROUND: Nowdays, modernization and industrialization cause many social problems and the abdominal stab wound is one of them. Recently, the number of accidents has increased along with the population of Puchen city where Holy Family Hospital is located. For the treatment of abdominal stab wounds, it is important to make a proper diagnosis. METHODS: We perform a retrospective clinical study of 52 patients who were operated on for abdominal stab wounds at Holy Family Hospital during the 10 years from January 1989 to December 1998. RESULTS: The age distribution revealed a high incidence in the twenties (44%), and the sex distribution, with a male-to-female ratio of 3:1, showed a male predominance. The seasonal distribution showed the highest incidence in the summer (35%) but there was no prominent difference in the seasonal incidence. It was made by others (44%), self (31%) and accident (25%) but 5 cases (10%) were made by the family circle. The most common clinical manifestations and the most commonly used instrument were abdominal pain (69%) and a knife (69%). In the most anemic patients, major vessel injury and thoracic injuries were combined. Among the 29 gastrointestinal injuries, 6 cases (21%) showed free air on radiologic study, and in the 13 cases with abdominal paracentesis, the sensitivity was 83% and the predictability was 91%. Among the abdominal injuries, except those to the omentum, the most commonly injured organ and combined organ were the small bowel (48%) and the thorax (55%). The average time interval from emergency-room treatment to surgery was 60 minutes. In 23 cases (45%), there was no blood transfusion during treatment. Blood transfusions above 11 units were required in 4 cases (2%). The complication rate was 15% and, no injured organs were overlocked. CONCLUSIONS: This review revealed that abdominal stab wounds were mainly caused by unknown male in their twenties, in the summer, and with a knife, but 10% were caused by number of the family circle. The diagnosis to operate was made with various methods, but we recommend a diagnostic laparoscopy with paracentesis in order to decrease negative laparotomies.